Edem Y Atakey, PHARM D
Individual provider Active NPI Pharmacist · New Haven, IN
NPI 1902206170 · NPPES record last updated Aug 25, 2014
Key facts
- NPI
- 1902206170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 26025802A (IN)
- Practice address
- 907 Lincoln Hwy W
New Haven, IN 46774-2141 - Phone
- (260) 493-3736
- NPI assigned
- Aug 25, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26025802A | IN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 26025802A | IN | Yes |
Addresses
Primary practice location
907 Lincoln Hwy W
New Haven, IN 46774-2141
Mailing address
5641 Ullyot Dr
Fort Wayne, IN 46804-2119
Phone (774) 386-1710
Other providers in New Haven, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.